Asymmetric bidirectional associations of myopia with anxiety and depressive symptoms: Evidence from a one-year follow-up of 40,575 Chinese adolescents.

BACKGROUND

Anxiety, depression, and myopia in adolescents are concerning public health issues. This study aimed to examine bidirectional associations between myopia and anxiety and depressive symptoms among Chinese adolescents, further providing empirical evidence for protecting and improving the well-being of adolescents.

METHODS

A two-wave online survey was conducted in Shenzhen, with an interval of one year. The two surveys recruited 101,032 and 90,705 adolescents, respectively, of whom 40,575 completed the follow-up and were included in the analysis. The measurements included a self-made sociodemographic questionnaire, the self-reported diopter, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-9. Multivariate logistic regression was used to test the relationship between myopia and anxiety and depressive symptoms.

RESULTS

The prevalence of myopia, anxiety, and depressive symptoms was 40.3 %, 7.2 %, and 10.2 % at baseline, and 55.2 %, 7.1 %, and 10.5 % at follow-up, respectively. Baseline moderate-to-high myopia was linked to an increased risk of anxiety and depressive symptoms both concurrently and at one-year follow-up. However, baseline emotional symptoms were only cross-sectionally associated with a higher risk of myopia. Additionally, adolescents with moderate-to-high myopia were at increased risk of developing new-onset emotional symptoms relative to those with emmetropia.

LIMITATIONS: All data were obtained through a self-reported questionnaire.

CONCLUSIONS

There is an asymmetric bidirectional association between myopia and symptoms of anxiety and depression in adolescents, with myopia more likely to act as a risk factor for these emotional symptoms than vice versa. It is recommended that vision care be incorporated as part of adolescent mental health promotion programs.